Active NPI
Dusty Marie Charbonneau, BCBA
- Behavior Analyst
- Wilbraham, MA
National Provider Identifier
1326623778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-43915
- Practice address
- 2 Hilltop Dr
Wilbraham, MA 01095-1743 - Phone
- (855) 832-6727
- NPI assigned
- Mar 16, 2021
- Last updated
- Mar 16, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-20-43915 | MA | Primary |
Addresses
Primary practice location
2 Hilltop Dr
Wilbraham, MA 01095-1743
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1326623778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 HILLTOP DR",
"city": "WILBRAHAM",
"state": "MA",
"postal_code": "010951743",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARBONNEAU",
"first_name": "DUSTY",
"middle_name": "MARIE",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-16",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "1-20-43915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilbraham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.